Heart Rhythm: Pulse vs. ECG Readings Explained - Cardiology

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Understanding the relationship between pulse readings and electrocardiogram (ECG) readings is crucial for grasping how heart rhythm abnormalities, such as arrhythmias, manifest in clinical practice. Both pulse and ECG provide valuable insights into heart function, but they measure different aspects of cardiac activity.


Pulse vs. ECG: What’s the Difference?
1. Pulse Measurement: The pulse is a tactile arterial palpation of the heartbeat. It is typically measured at various points on the body, such as the wrist (radial pulse) or neck (carotid pulse). The pulse rate reflects the number of times the heart beats per minute (BPM) and is influenced by various factors, including physical activity, stress, and overall cardiovascular health. When you feel your pulse, you are essentially feeling the pressure wave that travels through the arteries as blood is pumped from the heart.

2. ECG Measurement: An electrocardiogram (ECG) records the electrical activity of the heart over time. It provides a detailed view of the heart's rhythm and can identify abnormalities in heartbeats, such as arrhythmias, ischemia, or other cardiac conditions. The ECG displays the timing of electrical impulses that trigger heartbeats, which can be visualized as waves on a graph.

Correlation Between Pulse and ECG
In a healthy individual, the pulse rate and the heart rate recorded on an ECG should generally match. For example, if you feel a pulse of 100 BPM, the ECG should also show a heart rate close to 100 BPM. However, there are instances where discrepancies can occur, particularly in the presence of arrhythmias.

1. Arrhythmias: In cases of arrhythmia, the heart may beat irregularly. For instance, if a person has a rapid heart rate due to atrial fibrillation, they might feel a pulse that is rapid and irregular. The ECG would show an irregular rhythm, confirming the presence of an arrhythmia. In such cases, the pulse may not accurately reflect the underlying heart rate because some beats may not be strong enough to generate a palpable pulse.

2. Pulse Deficits: Sometimes, not every electrical impulse leads to a palpable pulse. For example, in conditions like ventricular tachycardia or certain types of heart block, the heart may beat rapidly, but not all beats result in effective blood flow, leading to a pulse deficit. This means that while the ECG may show a high heart rate, the pulse felt at the wrist may be lower than expected.

3. Measurement Timing: The timing of measurements can also affect readings. If a person is experiencing intermittent arrhythmias, there may be moments when the pulse is felt at a different rate than what is recorded on the ECG. This is particularly true if the ECG is recorded over a longer period (like a Holter monitor) and captures episodes of arrhythmia that may not be present during a brief pulse check.


Conclusion
In summary, while pulse and ECG readings are closely related, they can differ in the presence of heart rhythm abnormalities. A pulse of 100 BPM does not always guarantee that the ECG will also show 100 BPM, especially in cases of arrhythmias where some beats may not be effective. It is essential to interpret these readings in conjunction with clinical symptoms and further diagnostic evaluations. If you have concerns about your heart rhythm or experience symptoms like palpitations or irregular heartbeats, it is advisable to consult a healthcare professional for a comprehensive assessment. Regular monitoring and appropriate diagnostic tests can help manage any underlying conditions effectively.